Eastridge Family Dental
NPI #1700297967 in Kent, Washington
Provider Information
- NPI Number
- 1700297967
- Entity Type
- Organization
- Organization Name
- Eastridge Family Dental
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- May 9, 2014
- Last Updated
- May 9, 2014
Practice Location
- Address
- 24837 104TH AVE SE
- Address 2
- 103
- City
- Kent
- State
- Washington
- ZIP Code
- 98030-6800
- Phone
- (253) 277-2620
Authorized Official
- Name
- JAYANTHI BANTWAL, D.D.S
- Title
- DENTIST
- Phone
- (253) 277-2620
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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